“Sit Up Straight!” Does it Matter?

Think back for a moment, how often has a school teacher, parent, or friend told you to correct your posture? How many times has a healthcare provider mentioned to you that you need to improve your posture in order to reduce any neck or back pain you’ve been experiencing? This idea of correcting posture occurs quite frequently both socially and medically, and any healthcare providers attribute neck and back pain to poor posture as neck and back pain are among the most prevalent healthcare concerns. Often it has been hypothesized that technology and standard office equipment such as cellphones, desk chairs, or even desks themselves are to blame for poor spinal alignment and subsequent “sinister” posture. Most of us can picture what it looks like to have improper posture – head down, neck too far forward, rounded shoulders, or even a “neck hump” or “hunchback.” But, does it matter? Does your posture have much if any influence over your neck or back pain?

In short…no.

So, where does this ideology of perfect posture come from? Many theories exist, but a more common idea stems from military procedures. Historically, most military personnel where mandated to have ideal posture of a straightened vertical spine, straight neck, head up, chest out, and shoulders back all for a more aesthetic and professional appearance. This military posture is often the gold standard for what is considered perfect posture throughout history. As time progressed, it was also thought that this perfect military posture then transitioned into early fashion trends for women through the use of form fitting dresses and corsets. Further still, perfect posture was then utilized within public and catholic school systems; from there, the ideology of proper posture spun out of control into the healthcare fields to provide rationales to chronic neck and back pain. Today, you can find many articles and social media videos explaining how looking down for too long at one’s phone, texting, or slouching in a desk chair will ultimately cause longstanding discomfort over the spinal joints and associated musculature. However, it is imperative to be aware as a patient in today’s modern healthcare world of the potential scams or bias information offered to the public.

Chances are you may have come across articles in the past outlining how posture correlates to neck and back pain and may have shown you images of what improper posture looks like or what it may devolve into if you continue uncorrected. Be wary of articles like this as they are often not rooted in fact, they do not supply any valid research to support their claims, and they are almost always written by bias organizations such as office furniture companies or therapeutic equipment companies. Frequently, companies such as these will put out poor studies regarding posture to further feed into the false narrative of posture and pain in order to scare the general public into utilizing their services or buying their products.

So, what do valid research studies say about the correlation between posture and pain? Well, many come to the conclusion that there is no correlation between the two and that this notion of poor posture equating to long-term pain or increased postural deterioration is largely false. An article written by physician JP Keeve in 1967 largely gives information to how perfect posture was a “school health myth.” Furthermore, more recent studies such as one put out by Slater et al. in 2019 and Smythe et al. in 2021 additionally demonstrate that posture itself is often not the problem and rather stillness that gives rise to pain or discomfort – meaning it’s better to choose a comfortable posture and change positions periodically to avoid any pain. Humans have been looking down and slouching forward to read newspapers or books for centuries, so don’t let anyone tell you that your phone or texting is a problem. Don’t fall for any poor posture scams, postural correction videos, or bogus postural products! You are who you are, and almost nothing will permanently change your posture. The only benefits that come with perfect posture is that it’s aesthetically pleasing to the eye.

So, when the next person tells you to ‘sit up straight,’ just tell them it really doesn’t matter!

Mckeon Buffamonte, D.C.

Doctor of Chiropractic

Owner of PhysioDelta Chiropractic

References

·         Keeve JP. "Fitness," "posture" and other selected school health myths. J Sch Health. 1967 Jan;37(1):8-15. doi: 10.1111/j.1746-1561.1967.tb07013.x. PMID: 5180473.

·         Slater D, Korakakis V, O'Sullivan P, Nolan D, O'Sullivan K. "Sit Up Straight": Time to Re-evaluate. J Orthop Sports Phys Ther. 2019 Aug;49(8):562-564. doi: 10.2519/jospt.2019.0610. PMID: 31366294.

·         Smythe A, Jivanjee M. The straight and narrow of posture: Current clinical concepts. Aust J Gen Pract. 2021 Nov;50(11):807-810. doi: 10.31128/AJGP-07-21-6083. PMID: 34713281.